Posts by Nicholas Myers

mellowgardener15 said:Trying my luck here; I was completely ignored on a different thread. 😬

FSH 3.50 (1.8 - 9.4 IU/L)
LH 5.60 (0.8 - 10.4 IU/L)
PROLACTIN 518.00 (81 - 597 mlU/L)
DHEA-SO4 7.10 (1.8 - 9.8 umol/L)
ANDROSTENDIONE 19.20 (1.7 - 16.4 nmol/L)
TESTOSTERONE 4.50 (0.4 - 2.74 nmol/L)
ESTRADIOL 0.223 (0.11 - 0.65 nmol/L)

Regarding the bolded numbers: is this a significant elevation? Is medication usually recommended for this?

If more details are required, here is the post

Thanks. 🙂

Hello,

Regarding your lab results, here is my assessment.

The elevated testosterone level in your case is notable. Based on clinical standards, testosterone levels exceeding 3 nmol/l (yours is 4.50) are often associated with symptoms like hirsutism.

That said, free testosterone is a more precise marker.

As for the FSH and LH ratio, the LH is higher than the FSH. While a significant inversion is typically defined by an LH/FSH ratio of 3 or greater, there are certainly signs of inversion present here.

In any case, a consultation with a gynecologist is necessary, alongside discussing a pelvic ultrasound.

It would also be wise to consider testing progesterone levels.

Once those results are reviewed, appropriate treatment can be determined; oral contraceptives (such as Diane, Yaz, or Yasmin) are one potential option.

Best regards. 🙂

Keith Gonzalez said:Hospitalija? 🤷

I picked up my corner there, too. 🙂

analogbison13 said:I’m right there with you. I deal with plenty of stuff from that list myself, and honestly, it’s infuriating. After my colonoscopy, once they slapped an IBS diagnosis on me, nobody even thought to suggest seeing a psychiatrist. If they had, maybe I wouldn't be dealing with GERD today.
My family doctor used to tell me all the time that I was suffering from "Alexandrov illnesses." From what I understand, it refers to that so-called "seven" group of psychosomatic conditions.😉

That’s correct. According to Franz Alexander, there are seven distinct psychosomatic illnesses: gastric and duodenal ulcers, ulcerative colitis, bronchial asthma, essential hypertension, rheumatoid arthritis, hyperthyroidism, and psychocutaneous diseases. Seven Alexandrov diseases.

analogbison13 said:Nicholas Myers is familiar with those theories, and it's certainly not the first time I've heard them. But from my own experience—having been a mother to an asthmatic child for nine years—watching exactly how her attacks happen, from an allergen trigger to excess mucus production and finally the tightness in the lungs... I find it hard to buy into that theory. And if that were true, then sending a kid like that primarily to an allergist or a pulmonologist would be the wrong approach. 🤷

I already mentioned I don't entirely agree with that list, so I get where you're coming from.

The logic holds, though: if someone has a psychosomatic condition, they still need to see a specialist for the actual physical ailment. At the end of the day, a psychosomatic illness manifests in a specific organ, so you need a specialist to treat that organ. My point is simply that this should happen in tandem with a psychologist, psychotherapist, or psychiatrist.

Look, I’m not a psychiatry expert—that’s not my field—so I can't say for certain why organizations like the American Psychiatric Association have categorized asthma as a psychosomatic condition. It reminds me of a debate I once heard where an allergist and immunologist went after a psychologist, or maybe a psychiatrist, basically asking, "Oh, so you think we should treat anaphylactic shock with psychotherapy too?!"

The logic likely boils down to how mental states influence physical symptoms. Things like anxiety, stress, or general discontent can act as triggers for an attack.

Don't get me wrong; I'm not one of those people who believes everything is purely psychological. I'm just pointing out that this isn't some fringe theory someone made up; it’s actually documented in medical literature and research papers, just as my colleague mentioned.

analogbison13 said:My kid's been dealing with allergic asthma for years now, and honestly? I'm starting to suspect they developed some kind of 'psychosomatic illness' back when they were just two 😕

I have no interest in getting dragged into that debate, nor will I be weighing in on the matter. Instead, consider this one example. [Link] Regarding that specific issue.

The American Psychiatric Association has officially categorized asthma under the umbrella of psychosomatic disorders.

Sandra Rivera37 said:Great! Thanks so much for the reply. I just had an abdominal ultrasound; my liver looks fine, though my spleen is enlarged by about 10-20mm. My doctor says it’s negligible.

No big deal, I'm heading in to get my iron levels and thyroid hormones checked next.
My primary care physician is stumped.

I saw a specialist privately; they suspect an immune issue, especially given the Raynaud's syndrome (leeloo 🙂) and this psoriasis breakout.

If the ophthalmologist doesn't find anything, I'll see a neurologist. I'm hoping this cluster of symptoms points to a single cause so I can put this behind me soon. 🙂

(I'd really rather not bounce from specialist to specialist.)

Nicholas Myers, please—can those specific liver changes actually be seen on an ultrasound, or do you need other tests? Thanks.

Ma'am,

Looking back through your previous posts, I don't see any mention of existing liver lesions or changes.

You mentioned having spider angiomas. While these can indeed be present in patients with chronic liver disease, they also show up in perfectly healthy people, pregnant women, individuals with thyroid issues, or those on hormonal treatments like birth control.

Since vividsailor7 is participating here—and he's a board-certified gastroenterologist—it would be best if you posted your full ultrasound report. He’ll be able to provide a proper assessment and guidance.

Dear David Brown5,

Given what you've shared regarding your medical history, I would strongly suggest scheduling a consultation with an internist. It would be wise to take photos of those specific changes to show them during your appointment.

An eye exam might help rule out certain types of headaches—specifically ocular ones, though those are less common than other causes—but things like migraines, tension headaches, or sinus issues fall outside an ophthalmologist's scope. Generally speaking, an eye exam won't diagnose those types of headaches, so there is no guarantee that a visit to the eye doctor will uncover the root cause of your pain.

It is also entirely possible to have perfectly normal liver enzyme levels while still dealing with viral hepatitis. For instance, nearly a third of patients living with chronic Hepatitis C who show clear physical changes in the liver actually present with normal serum aminotransferase values.

Best regards. 🙂

Sandra Rivera37 said:Well, the doctor just waves it off because the labs look fine. She claims an abnormal MPV doesn't mean anything if everything else is within range.
She doesn't pay much attention to those specific levels if my platelet count and PV are okay.

Ma'am,

Is this bruising tendency a recent development, or has it been going on for a long time? Does anyone else in your family deal with easy bruising? Are you experiencing any other bleeding—nosebleeds, bleeding gums—or perhaps joint swelling? Are you currently taking any medications?

Where do these bruises typically show up? Are they appearing on your torso, neck, or face? Any other symptoms like fatigue, weight gain, thin skin, or purple stretch marks? How would you describe your menstrual cycles—are they normal or unusually heavy?

Roughly how large are these bruises? Larger than a quarter? When you touch them, are they harder than the surrounding skin, or can you feel a lump?

Do they appear spontaneously, or is it more that the bruising seems disproportionately large compared to the impact or injury?

Are you frequently using things like aspirin or other NSAIDs?

What other tests have you had done? You mentioned a coagulation panel.

Generally speaking, spontaneous bleeding falls into three main categories: issues with the blood vessel walls, problems with the number or function of platelets, or disorders in the blood clotting system.

The first two groups usually result in bruising on the skin or mucous membranes. Clotting disorders tend to lead to bleeding into joints and internal organs.

In younger women, spontaneous bruising—mostly on the legs—can occur even when there are no underlying issues with platelets or clotting factors. This is essentially a tendency for small capillaries in the skin to rupture, known as purpura simplex. However, without a clinical exam, it’s impossible to say for certain what we're looking at.

Moderator Notice

This thread was created by spinning off posts from the "GERD [stomach issues]" topic. Please disregard any previous comments regarding off-topic remarks; those were made in the context of the old thread. Now that they have been moved here, they belong in this discussion.>

To start things off, here is a standard definition and a brief list of psychosomatic conditions:

"Psychosomatic illnesses can be defined as physical ailments within various organ systems where a psychogenic factor is believed to play a significant role.>

According to the American Psychiatric Association, psychosomatic diseases include:

1. Skin disorders: acne, hives, neurodermatitis (chronic skin changes involving intense itching), and angioedema (swelling of the eyelids, lips, tongue, etc.),
2. Digestive system disorders: spasms in the muscle between the esophagus and stomach, the stomach and duodenum, gastric and duodenal ulcers, chronic constipation, ulcerative colitis, and Crohn's disease,
3. Respiratory system disorders: bronchial asthma and tuberculosis,
4. Cardiovascular diseases: angina pectoris and myocardial infarction, high blood pressure, arrhythmias,
5. Endocrine disorders: diabetes, low blood sugar (hyperinsulinism and hypoglycemia), hyperthyroidism,
6. Rheumatic diseases: rheumatoid arthritis, chronic lower back pain,
7. Gynecological issues: painful menstruation, miscarriages,
8. Other: obesity, allergic reactions, migraines and other headaches, chronic itching, tumors.

Nowadays, cancer is even considered within the realm of psychosomatic illness. Determining exactly how and why a psychosomatic condition develops isn't simple or straightforward. Many researchers suggest that emotional turmoil can trigger disruptions in organic systems. However, not everyone facing emotional struggles will develop a psychosomatic illness. It depends on several variables, such as genetics, life stressors, social support networks, and cultural factors.

Excerpted from Psychosomatics, D. Romac, MD, psychiatrist, Healthy Living, a family health magazine, Issue 56/2008.

To provide some context for this discussion, I am including snippets from the original thread (which focused on GERD—gastroesophageal reflux disease). These specific comments sparked the ongoing debate:

hrvoje dr. said:GERD is largely a psychosomatic condition; it isn't incurable. ...

analogbison13 said:I don't quite get how my inflamed lining has been psychosomatic for two years... sure, the symptoms are much milder now, but who knows, maybe there's already permanent damage to my esophagus. 🙄

And what about children diagnosed with GERD and Barrett's esophagus? For them, I assume the cause isn't psychosomatic, but rather chemical or mechanical.

AnnaMollyHr said:...In other words, most of us—mostly the younger crowd who met through this forum or this specific thread—are hypersensitive. We're over-educated. We read too much, then we read even more, second-guessing every single symptom or minor ache until the ailment becomes psychosomatic.

Given the daily grind and the stress we deal with, it’s hardly surprising...

At the very least, one can try to fix their diet and lifestyle—just slow down, if nothing else. 🙂

dr. hrvoje said:...Asthma, ulcerative colitis, hypertension, hives, dermatitis, ulcers, etc.—these all fall under psychosomatics. I'm not sure why reflux would be considered an exception here.
We need to define what "children" actually means in this context—as in, age range.

restlessbadger2, I'll follow up with you via DM. 🙂

Dear restlessbadger2,

I have reviewed the posts you shared.

From what I can gather, your pattern during specialist consultations involves a diagnosis of fungal infection—with one instance involving a suspicion of genital herpes—followed by microbiological swabs and subsequent treatment for Candida.

There is an interesting detail here: if I am reading this correctly, when you saw the dermatologist, you were experiencing active symptoms and visible changes, yet the Candida culture came back negative; at that point, one physician suspected genital herpes due to the ulcerations.

In medical literature regarding recurrent vulvovaginal candidiasis, some authors suggest that if two separate cultures fail to detect Candida during an active symptomatic period, Candida should be ruled out as the primary cause, and alternative diagnoses should be explored.

This scenario occurred once in your case, but even that single instance—combined with the fact that none of the prescribed anti-fungal treatments seem to have provided relief (specifically regarding the burning sensation and physical changes)—suggests we should consider whether these issues are truly caused solely by Candida or by something else entirely.

Do you happen to know what the dermatologist noted in her findings once those negative culture results arrived? Specifically, how was that erythema interpreted, or did she offer a specific diagnosis or conclusion following that second examination and the swab results?

While vulvodynia is a possibility, the presence of mucosal and physical changes raises the question of whether there is an underlying organic cause for your symptoms. It is worth noting that contact and allergic dermatitis exist; allergic reactions can often stem from ingredients found in the very creams used to treat Candida.

I also encountered research suggesting that prolonged Candida infections can, in certain instances, lead to alterations in both the mucosa and the nerve endings that innervate the area, which could potentially trigger vulvodynia.

A specialist like Dr. Škerk would need to definitively rule out an infectious basis for your symptoms, especially since current discussions seem heavily focused on an infectious cause, primarily Candida.

restlessbadger2 As requested:
I’m looking for answers because I’ve been stuck in this cycle of vaginal infections for about six months now. Every time I go in, it’s a different label—first it's vulvovaginitis, then they pivot to candidiasis. The symptoms have become my constant companions: persistent redness of the anogenital mucosa and erythematous patches on the labia minora, which doctors claim is just the yeast. Then there’s the burning sensation in the vulva and vagina. It’s maddening. I can't tell if the burning is a symptom itself or if it's just the result of damaged tissue.

To whom it may concern,

Your situation is highly complex. Even from this point, it is clear that a multidisciplinary approach will be necessary to resolve the issue—essentially, you'll need to coordinate consultations across several different specialists.

There are many variables at play here. As you’ve already noted, a positive Candida culture and a diagnosis of candidiasis might not be the sole explanation for everything you're experiencing.

When considering the causes, one has to look beyond infectious vulvovaginitis to include dermatological conditions and vulvodynia. I see the Women's Health moderators have already taken those factors into account.

I’d suggest scheduling a consultation with specialists beyond just an infectious disease expert—though I agree with Petrov's recommendation to see her. You really need a solid dermatologist on your side too. Given that you mentioned both erosion and redness, we shouldn't rule out a dermatological diagnosis or even those rare skin conditions that aren't immediately obvious. If things don't start improving, one of these experts might eventually suggest a biopsy of the affected areas. That could be the key to getting a definitive diagnosis.

Has anyone here actually consulted a gynecologist working within a major clinical institution? I’m talking about specialists at places like the Mayo Clinic or similar large-scale hospital systems.

To get straight to the point, I just got my results back:

Microbiology report: stool sample. Native prep came back negative. Stained prep also negative. Conclusion: no Candida in the gut.
Serum testing (bloodwork) for antibodies against Candida spp. This was conducted using three different methodologies.
IIF - IgG: result 80 (reference range: 1 to ≤ 80)
b) IHA - IgM/IgG/IgA: result is 160 (reference range: 1 to ≤ 160)
c) ELISA - IgG: result is 90 (reference range: 40–100)

These results are borderline. How much weight should I give them—are we looking at a red flag or just noise? Is there any actual risk of systemic candidiasis here?

The role of serology in diagnosing candidiasis remains somewhat murky. One has to be incredibly cautious when interpreting these results. Recent infectious disease literature suggests these tests lack sufficient sensitivity and specificity. You shouldn't prescribe therapy based solely on these numbers; instead, treatment decisions should rely on the broader clinical picture and other diagnostic findings.

People dealing with invasive or systemic candidiasis are generally quite ill. We're talking about life-threatening situations where the immune system has been severely compromised—usually due to conditions like HIV/AIDS, cancer, or the fallout from chemotherapy.

Vaginal fungal swab results are in: the native prep came back positive, the stained prep was also positive, and the culture identified *Candida albicans*.
-They treated the yeast with various chemical agents, and it showed sensitivity to all of them—meaning they work. However, I don't understand why none of these medications have helped me if the yeast is sensitive to them.???

Regarding *C. albicans*, it typically doesn't show resistance. This raises the question: did you feel any improvement or reduction in symptoms, even briefly, while using the prescribed therapy?

Here are the chemical substances:
-5-fluorocytosine: S (MIC = 4.000)
-amphotericin B: S (MIC = 0.500)
-fluconazole: S (MIC = 1.000)
-itraconazole: S (MIC = 0.125)
-voriconazole: S (MIC = 0.060)

What does MIC mean? Which of these substances would be best at clearing the yeast? Is it the first one with an MIC of 4.000?

The colleague, vividsailor7, gave you a brief explanation of the definition. Put simply, the lower the MIC value, the more potent the effect. Primarily, the MIC value serves to determine whether a pathogen is sensitive or resistant to a specific drug.

In your specific case, some drugs on this list are off the table. For example, voriconazole (Vfend) is reserved strictly for treating systemic fungal infections in immunocompromised patients, usually within a hospital setting. The same applies to amphotericin.

Fluconazole is Diflucan, and itraconazole is Itraconazole.

As for treating vulvovaginal candidiasis, there are different protocols depending on whether you are dealing with an acute infection or recurrent cases. For recurrent issues, special regimens exist where suppressive therapy (lasting up to 6 months) is applied following the standard treatment.

The critical question remains: did any of the prescribed preparations provide even slight relief?

Best regards. 🙂

Jessica Diaz66 said:I have a question. Since I've discovered my homocysteine levels are high, I've been reading that taking folic acid, vitamin B12, and B6 can help lower them. Is this considered a good course of treatment?

Hello,

Regarding those elevated homocysteine results: you need to consult with your primary physician or an internist. They will evaluate your overall cardiovascular risk profile. If that risk is deemed high, they might prescribe different treatments altogether—things like antiplatelet medications or lipid-lowering drugs, for instance.

As for "treating" high homocysteine specifically, the science is still catching up. Studies are ongoing, but there isn't a clear medical consensus yet on whether the supplements you mentioned are necessary, if they actually reduce cardiovascular risk, or even what the precise dosages and durations should be. Because of that uncertainty, I strongly recommend discussing this directly with your doctors.

Best regards. 🙂

Jesse Reed3 said:I was mowing the lawn and I’m clearly allergic to some kind of grass, though I'm not sure which one. My arms are covered in blisters. Does anyone know how to treat this, or am I looking at a mandatory doctor visit?

Hello,

The reaction you're describing isn't necessarily an allergy.

There is a condition known as bullous phytophotodermatitis—essentially a group of phototoxic dermatoses.

It isn't an allergic response per se. Rather, it's an inflammatory reaction triggered when skin (often damp from sweat or dew) comes into contact with certain plant compounds and is subsequently exposed to UV rays.

Mowing the lawn during the summer months is a classic scenario for this, particularly on the forearms.

Symptoms typically involve intense itching accompanied by redness and small or large blisters. The itching often peaks at night, frequently disrupting sleep. These skin changes manifest shortly after contact with the vegetation and can spread over the next forty-eight to seventy-two hours. Usually, they begin to subside within about a week.

If you develop large blisters or a more severe presentation, there is also the risk of secondary infection, especially if the blisters rupture. In those cases, a trip to the doctor is necessary. Severe instances are often treated with corticosteroid lotions, while infections require antibiotic creams.

In the interim, alongside the previously mentioned antihistamines to manage the itch, cold compresses may provide relief.

Regardless of whether this is an allergy or a phototoxic irritation, if things take a turn for the worse, seek medical attention.

Best regards. 🙂